Myths About Sex – From a Pelvic Floor Specialist

As a physical therapist specializing in the pelvic floor, I have become more aware of the considerable number of people dealing with sexual pain in our society. And not just physical, but emotional and spiritual pain. I want to take the time to address these myths and hopefully encourage you to seek out whatever healing and restoration you need.

Myth #1: It is normal for sex to hurt sometimes

Sadly, many women have come to accept the lie that it is normal for sex hurt sometimes (especially the first time), and that sex is naturally more pleasurable for men. This is even accepted within the medical community.

Many clients have been told to just “give it time” or that they will “get used to it.” As it turns out, these women will then usually wait about 5 years before revisiting the issue. Meanwhile, without proper guidance, women are just powering through the pain. The problem with trying to power through pain is that the body eventually shuts down, which is very different from “getting used to it.”

Sex will change through different seasons of our lives. It is not something that starts and ends on your wedding night but a journey that progresses through the years as our bodies, relationships, heart, and our mind mature. Vaginismus, dyspareunia, coccydynia, changes with menopause and other sexual dysfunctions can occur at different times of your sexual journey. But the bottom line is this: Pain is information. Your body is telling you that something is wrong. Don’t ignore it.

Myth #2: Desire and frequency decreases with pregnancy and childbirth

As pregnancy advances, many women have reported that they have decreased frequency and desire for sexual intimacy. However, it is not usually about discomfort or body image. It is usually the fear of hurting the baby or getting an infection. Having a pelvic floor specialist guide you through sexual activity during pregnancy helps to relieve some of that anxiety.

Hormone imbalances, muscle imbalances, prolapse, and scar tissue are some of the reasons women have issues after birth. In our experience, women will have fewer issues if able to be seen by a physical therapist for core and pelvic floor rehabilitation. It is best to be seen prenatally as well as when resuming sexual activity postpartum. But some treatment is always better than no treatment. Sex is too important to let fear and anxiety get in the way.

Myth#3: Sexual pleasure is not as important to women

It is a myth that men always want sex more than women, and that what they need is to “relieve tension.” This myth has created anxiety for many women with the expectation that they need to accommodate their partners by “playing their part,” rather than listening to their own intimate instincts.

Even as late as the 1970’s, some doctors were claiming that female orgasms did not exist, or that it was normal for women not to experience one. I have worked with many women who have been sexually active for decades and have never experienced orgasms. It is unfortunate that so many women have disconnected from their sexuality for different reasons, but it does not mean it is normal. Sex was created to heal. It should be nourishment for both partners involved.

Our modern lifestyles have lead us away from our bodies intended function. As a result, many of us are suffering from weak or overused muscles in the core and pelvic floor. Our posture, exercise choices, and even the way we walk affect which muscles are used – including the deep muscles of the pelvic floor. Most of us are not using those muscles effectively, resulting in the imbalances that contribute to uncomfortable or painful sex.

Many physical conditions that affect sexual intercourse are treatable and have high success rates. Our bodies were not built to suffer. Don’t push through pain or deal with an unfulfilled intimate life any longer. There is hope. There is healing. Let us help.

4 responses to “Myths About Sex – From a Pelvic Floor Specialist”

Thank you for speaking out and teaching on such an important topic – sexual intimacy is a gift many women don’t experience due to pain, disconnection, and a multitude of reasons. It’s tragic that in our “modern, enlightened society”, this is still a taboo subject. I am glad you are educating women that it is “common” but not “normal” – we just need to know how and where to find help (and not be too embarrassed to ask for it!)

I had pain during sex the entire time I was breastfeeding my first (1 year). I did everything I was told to do – taking it slow, lots of foreplay and lube, etc, but nothing helped. As soon as I weanned him things returned to normal, but then I got pregnant again right away. I’m 3 weeks postpartum now and am nervous to have the same experience this time around. My husband has been so patient, but I just want to have normal sex again – for his sake, yes, but for mind too! Any tips or resources you can recommend to help? Thanks in advance!

There is still a lot of swelling and hormonal changes going on 3 weeks postpartum but it can be helpful to see a pelvic floor physical therapist as early as 4 weeks PP. We typically have people come in between 6-8 weeks. It is good to have an assessment to see the cause of the pain and treat accordingly. Avoid sit ups, crunches and planks and running as it can cause the PF to overcompensate. Floor of the core educates you on the anatomy and function of the PF and how to use the PF and TA efficiently to restore connection and strength so that they can use those muscles functionally.

A helpful resource is the book “Sex Without Pain” by Heather Jeffcoat which is on Amazon.

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